To the Editor: The CONKO-001 study of adjuvant gemcitabine for resected pancreatic cancer by Dr Oettle and colleagues1 reported improved disease-free survival with the addition of chemotherapy compared with observation. The total rate of local recurrences in this study was approximately 40% in both groups, which appears low when compared with other published data. Local recurrence was a component of failure in 62% of all recurrences in the ESPAC-1 trial, which included 69 patients who also received no adjuvant therapy following surgery.2